Hot flushes (called 'flashes' in North America) are the most common symptom of menopause, affecting around three-quarters of all menopausal women. Usually, they are no more significant than a feeling of heat or a slight sweat on the face, neck and chest, but some women notice that their heart beat is elevated or that they feel a bit anxious.

Whether they happen only one or two times a day, or more like 15 or 20, hot flushes are hard to ignore, especially as they are likely to continue for at least a couple of years, and, when they occur at night, can cause disrupted sleep (leading potentially to fatigue and depression).

Until recently, the conventional medical response has usually been Hormone Replacement Therapy (HRT), which replaces the oestrogen that your ovaries no longer produce. HRT can make hot flushes go away completely as well as solve the problem of vaginal dryness and disturbed sleep - which makes it sound great, except that recent research has shown that HRT leaves you more at risk of developing a serious blood clot, breast cancer, stroke, heart attack and ovarian cancer.

In reponse to these concerns about HRT, more women are trying out the alternatives.You'll hear your more experienced menopausal friends swear by black cohosh, red clover, dong quai, evening primrose oil, ginseng, and vitamin E. Clinical studies have shown black cohosh to be the most effective at easing hot flushes, but not much is known about its long-term effects. Red clover may or may not help (results are contradictory), and some species are unsuitable for women who are taking anticoagulants. As for the others? Clinical scientists say they don't do a thing to help, but some women swear they get good results - even if it's only because of the placebo effect.

If you're determined not to intervene biochemically with your hot flushes, you can lessen the symptoms by:

• Keeping your living space at a slightly cooler temperature.
• Keeping a handheld fan in your bag and pretending, when you whip it out, that you're in training as a geisha.
• Dressing in layers that can come off easily if need be.
• Drinking plenty of water and avoiding too much caffeine, alcohol and spicy food if these provoke a flush.
• Exercising regularly to help stabilise hormones and prevent insomnia.
• Keeping your sense of humour by whatever means possible!

Article by Rosemary Hepozden

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